Name of the Procedure:

Repair umbilical hernia, younger than age 5 years; incarcerated or strangulated

Summary

This surgical procedure is performed to repair an umbilical hernia— a condition where a part of the intestine protrudes through an opening in the abdominal muscles near the belly button— in children younger than five years old. The focus is on cases where the hernia is incarcerated (trapped) or strangulated (blood supply cut off), requiring urgent intervention.

Purpose

The procedure addresses umbilical hernias that have become incarcerated or strangulated, which can cause severe pain, tissue damage, or even infection. The goal is to repair the hernia, prevent complications, and alleviate symptoms to ensure normal abdominal function.

Indications

• Visible bulge near the belly button
• Pain or tenderness at the site of the hernia
• Swelling, redness, or discoloration around the naval
• Nausea or vomiting
• Incarcerated or strangulated hernia diagnosed by a healthcare professional

Preparation

• The child may need to fast for several hours before the procedure.
• Inform the surgeon about any medications the child is taking; some may need to be adjusted or stopped.
• Preoperative assessments, such as blood tests or imaging studies, may be required.

Procedure Description

1. The child is given general anesthesia to ensure they are asleep and feel no pain.
2. A small incision is made near the belly button.
3. The protruding intestinal tissue is gently pushed back into the abdominal cavity.
4. The abdominal muscle opening is closed and reinforced, typically with sutures.
5. The incision is closed with stitches or surgical glue.
6. A sterile bandage is applied to the site.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

The surgery is typically performed in a hospital operating room or a surgical center.

Personnel

• Pediatric surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Common: Infection, bleeding, recurrence of the hernia
• Rare: Damage to surrounding tissues or organs, adverse reactions to anesthesia
• Complications are managed with appropriate medical interventions as needed.

Benefits

• Relief from pain and discomfort caused by the hernia
• Prevention of serious complications like tissue damage and infection
• Improved abdominal function and child's well-being

Recovery

• The child will be monitored in the recovery room until they wake up from anesthesia.
• Pain can usually be managed with prescribed medications.
• Activity may be restricted for a few weeks— follow specific postoperative instructions.
• Follow-up appointments will be scheduled to ensure proper healing.

Alternatives

• Watchful waiting if the hernia is not incarcerated or strangulated.
• Non-surgical management strategies may be recommended in less severe cases, but they are generally less effective for incarcerated or strangulated hernias.

Patient Experience

• During the procedure: The child will be under general anesthesia and should not feel any pain.
• After the procedure: Some discomfort or pain at the surgical site is expected, which can be managed with pain relief medications.
• Close follow-up is essential to monitor recovery and address any concerns.

This markdown provides a comprehensive yet accessible overview of the procedure to repair an umbilical hernia in children, especially those cases that are incarcerated or strangulated.